PRIVATE AND CONFIDENTIAL

/

APPLICATION FORM

Please return your completed form by email to:
Or post to:
Bill Armitage, DanceEast, Jerwood DanceHouse,Foundry Lane,
Ipswich, Suffolk IP4 1DW marked ‘Private & Confidential’
POST APPLIED FOR
FIRST NAME / SURNAME
ADDRESS
POSTCODE / YOUR E-MAIL ADDRESS
PHONE NUMBERS
·  DAYTIME :
·  EVENING :
·  MOBILE :
ARE YOU AWARE OF ANY REASON WHY YOU WOULD NOT BE ABLE TO WORK IN THE UK? (If yes, please give details) / YES / NO
DO YOU NEED EITHER A WORK PERMIT OR PERMISSION TO WORK IN THE UK? (If yes, please give details)
HOW DID YOU FIND OUT ABOUT THE POST
CURRENT OR MOST RECENT EMPLOYMENT
NAME OF ORGANISATION
ADDRESS
DATE STARTED
/ DATE FINISHED
/ CURRENT SALARY
JOB TITLE / POST HELD
PLEASE OUTLINE YOUR MAIN RESPONSIBILITIES AND DUTIES
REASON FOR LEAVING OR SEEKING OTHER EMPLOYMENT
PREVIOUS EMPLOYMENT
NAME AND ADDRESS OF ORGANISATION / JOB TITLE, RELEVANT DUTIES & SKILLS / DATES / REASON FOR LEAVING
SUMMARY OF OTHER PREVIOUS EMPLOYMENT IF RELEVANT
PLEASE GIVE THE NAMES & ADDRESSES OF TWO REFEREES, INCLUDING YOUR MOST RECENT EMPLOYER (references will be requested only once an offer of employment has been made, unless otherwise requested)
Name:
Position:
Address:
Postcode:
Daytime phone:
Evening phone:
Mobile:
E-mail:
/ Name:
Position:
Address:
Postcode:
Daytime phone:
Evening phone:
Mobile:
E-mail:
May we request a reference:
At any time
Only after an offer of employment
/ May we request a reference:
At any time
Only after an offer of employment
EDUCATION (please list secondary, further and postgraduate education)
EDUCATION INSTITUTION /

DATES

/ QUALIFICATIONS OBTAINED
ACADEMIC / PROFESSIONAL QUALIFICATIONS (please list any other qualifications you hold not listed above)
QUALIFICATION / DATES / NAME OF INSTITUTION OR AWARDING BODY
VOLUNTARY POSITIONS / WORK (please list any Board positions and other voluntary work)
POSITION / WORK / DATES / ORGANISATION
WHY DO YOU FEEL YOU ARE THE IDEAL CANDIDATE FOR THIS POST?
In no more than 1,000 words please describe why you are attracted to the post, your relevant experience, ability to meet the person specification and any other information that you feel makes you the ideal candidate for this post.
CV’s will only be accepted when accompanying a completed Application Form
OTHER INFORMATION

In line with the Disclosure Code of Practice all information provided below will be handled securely and confidentially, having due regard to appropriate legislation including data protection. Any information will not be used to treat individuals unfairly or to discriminate but will be considered along with other relevant information from the recruitment process.

If you were invited to attend an interview would you have any special access needs? If yes, please give details.

(Please note the Jerwood Dancehouse is fully accessible to wheelchair users)

If appointed, when could you start work?
Do you hold a current UK driving licence?

If you were appointed to this position would you have any special access or other needs to carry out your duties? If yes, please give details.

Is there anything concerning your medical history or state of health that is relevant to your application? If yes, please give details.

Please state how many days you have been absent from work due to illness dung the past two years, providing details for any extended absence period.

Do you have any convictions, cautions, reprimands or final warnings that are not “protected” as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)? If yes, please give details.

DECLARATION (Please read carefully before signing this application)
I declare that the information contained in this application is correct to my knowledge and belief. I understand that my application may be rejected or that I may be dismissed for withholding relevant details or giving false information. I consent to DanceEast checking any information that I am unable to verify personally.
I agree that should I be successful in this application as an employee of DanceEast I may be required to apply to the Disclosure & Barring Service for an enhanced check. I understand that should I fail to do so, or should the disclosure not be to the satisfaction of the company any offer of employment may be withdrawn or my employment terminated.
I acknowledge and accept that my data will be stored securely in manual and electronic records and will be processed solely by DanceEast in connection with the recruitment and equal opportunities monitoring of and my personal records if I am the successful candidate.
Signed: Date:
Please note that if you are completing and sending this form electronically you will be required to sign it if appointed.